Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Rue du Bugnon, 46, 1005, Lausanne, Switzerland.
BMC Surg. 2022 Mar 30;22(1):122. doi: 10.1186/s12893-022-01572-5.
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has been introduced for palliative treatment of peritoneal surface malignancies (PSM) and is currently tested also in the neoadjuvant and prophylactic setting. The aim was therefore to compare safety and tolerance of staging laparoscopy with or without PIPAC.
This retrospective analysis compared consecutive patients undergoing staging laparoscopy alone for oesogastric cancer with patients having PIPAC for suspected PSM of various origins from January 2015 until January 2020. Safety was assessed by use of the Clavien classification for complications and CTCAE for capturing of adverse events. Pain and nausea were documented by use of a visual analogue scale (VAS: 0-10: maximal intensity).
Overall, 25 PIPAC procedures were compared to 24 staging laparoscopies. PIPAC procedures took a median of 35 min (IQR: 25-67) longer. Four patients experienced at least one complication in either group (p = 0.741). No differences were noted for postoperative nausea (p = 0.961) and pain levels (p = 0.156). Median hospital stay was 2 (IQR: 1-3) for PIPAC and 1 (IQR: 1-2) for the laparoscopy group (p = 0.104).
The addition of PIPAC did not jeopardize safety and postoperative outcomes of staging laparoscopy alone. Further studies need to clarify its oncological benefits.
加压腹腔内气溶胶化疗（PIPAC）已被引入用于姑息性治疗腹膜表面恶性肿瘤（PSM），目前也在新辅助和预防环境中进行测试。因此，目的是比较单独进行分期腹腔镜检查与联合 PIPAC 的安全性和耐受性。
这项回顾性分析比较了 2015 年 1 月至 2020 年 1 月期间，单独接受腹腔镜检查用于治疗胃食管癌的连续患者与因各种来源的疑似 PSM 而接受 PIPAC 的患者。并发症的安全性评估采用 Clavien 分类，不良反应的捕获采用 CTCAE。疼痛和恶心通过视觉模拟评分（VAS：0-10：最大强度）进行记录。
总共比较了 25 例 PIPAC 手术和 24 例分期腹腔镜检查。PIPAC 手术的中位数时间延长了 35 分钟（IQR：25-67）。两组各有 4 例患者至少出现了一种并发症（p=0.741）。两组术后恶心（p=0.961）和疼痛水平（p=0.156）均无差异。PIPAC 组的中位住院时间为 2 天（IQR：1-3），腹腔镜组为 1 天（IQR：1-2）（p=0.104）。
联合 PIPAC 不会危及单独进行分期腹腔镜检查的安全性和术后结果。需要进一步的研究来阐明其肿瘤学益处。
